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Background The Spanish National Health System (NHS) faces a significant shortage of clinical psychologists with only 5.58 per 100,000 inhabitants. This study aimed to estimate the required number of specialists and residents in Clinical Psychology to provide adequate psychological treatments to the population in the NHS. Methods A needs-based model was adapted to forecast the required total number of clinical psychologists and the annual increase in the positions of residents in Clinical Psychology (PIR). This model followed five steps: (1) obtaining Spanish prevalence rates for three broad mental disorder categories (depression, anxiety, and others or severe mental disorders) from the 2017 National Health Survey (ENSE); (2) multiplying the prevalence rates by the Spanish population aged ≥ 15 years; (3) defining the percentage of cases eligible for treatment under three predefined scenarios (protocolized, intermediate, and adjusted); (4) operationalizing the characteristics of the three treatment scenarios (session number and duration); and (5) calculating the total number of clinical psychologists and the annual increase required for PIR positions. Results Depending on the treatment scenario, the estimations show a need for clinical psychologists ranging from 1665 to 13,527 for treating depressive disorders, 1792–9799 for anxiety disorders, and 2074–8294 specifically for severe mental disorders. On the other hand, depending on the treatment scenario and the timeframe to achieve the estimated number of professionals (within 3, 5, 8, or 10 years), for example, to achieve those estimations of professionals within 3 years, and according to the adjusted treatment scenario, the Spanish health system should offer approximately 481 PIR positions yearly during 3 years. Conclusions A significant increase in the number of PIR positions is necessary to meet the growing demand for psychological treatment in the Spanish NHS. Investing in a mental-health workforce can lead to substantial health and economic benefits. This study provides valuable insights for workforce planning and highlights the importance of addressing the shortage of clinical psychologists in the NHS.

This study explored how neighborhood characteristics may relate to African American adolescents' internalizing symptoms via adolescents' social support and perceptions of neighborhood cohesion. Participants included 571 urban, African American adolescents (52% female; M age = 17.8). A multilevel path analysis testing both direct and indirect effects of neighborhood characteristics on adolescents' mental health outcomes was conducted. Higher neighborhood poverty and unemployment rates predicted greater internalizing symptoms via lower cumulative social support and perceptions of neighborhood cohesion. In contrast, higher concentrations of African American and residentially stable residents in one's neighborhood related to fewer internalizing symptoms among adolescent residents via greater cumulative social support and perceptions of neighborhood cohesion. Implications of these findings are discussed.

INTRODUCTION Few evidence‐based psychosocial interventions target people with advanced dementia. METHODS Namaste Care Family is a daily multi‐dimensional care program to improve quality of life (QoL) of people with dementia and their family caregivers. In this cluster‐randomized controlled trial, adjusted linear mixed models were used to analyze effects at 1, 3, 6, and 12 months follow‐up. Ten nursing homes implemented the program (n = 116) while nine nursing homes provided care as usual (n = 115). RESULTS The intervention group showed less discomfort (−1.06; 95% confidence interval [CI] = −1.88 to −0.23) and fewer sentinel events (‐0.40; 95% CI = −0.64 to −0.16), specifically pneumonia (−0.08; 95% CI = −0.14, −0.02). There were no differences in residents’ QoL, challenging behavior, and medication use. There was no effect on positive caregiving experiences, caregiver burden or guilt, whereas conflict with staff was lower at 12 months (−2.04; 95% CI = −4.07 to −0.01). DISCUSSION Namaste Care Family has some beneficial effects on residents with dementia and family caregivers. Clinical Trial Registration: This trial was registered with the CCMO Research with human participants (old ID 5692/new ID 5570). Highlights Namaste Care Family involves family in a daily program for residents with dementia. Residents’ quality of life did not improve (primary outcome) due to the program. Also, family's positive caregiving experiences did not improve (primary outcome). Namaste Care Family reduced discomfort and sentinel events in people with dementia. Family caregivers’ conflict with staff over caregiving decreased due to the program.

Vaccine hesitancy presents an obstacle to the campaign to control COVID-19. It has previously been found to be associated with youth, female gender, low income, low education, low medical trust, minority ethnic group membership, low perceived risk from COVID-19, use of certain social media platforms and conspiracy beliefs. However, it is unclear which of these predictors might explain variance associated with others. An online survey was conducted with a representative sample of 4343 UK residents, aged 18-75, between 21 November and 21 December 2020. Predictors of vaccine hesitancy were assessed using linear rank-order models. Coronavirus vaccine hesitancy is associated with youth, female gender, low income, low education, high informational reliance on social media, low informational reliance on print and broadcast media, membership of other than white ethnic groups, low perceived risk from COVID-19 and low trust in scientists and medics, as well as (to a much lesser extent) low trust in government. Coronavirus conspiracy suspicions and general vaccine attitudes appear uniquely predictive, jointly explaining 35% of variance. Following controls for these variables, effects associated with trust, ethnicity and social media reliance largely or completely disappear, whereas the effect associated with education is reversed. Strengthening positive attitudes to vaccination and reducing conspiracy suspicions with regards to the coronavirus may have a positive effect on vaccine uptake, especially among ethnic groups with heightened vaccine hesitancy. However, vaccine hesitancy associated with age and gender does not appear to be explained by other predictor variables tested here.

ABSTRACTObjectivesOne-on-one structured Montessori-based activities conducted with people with dementia can improve agitation and enhance engagement. These activities may however not always be implemented by nursing home staff. Family members may present an untapped resource for enabling these activities. This study aimed to evaluate the impact of the Montessori activities implemented by family members on visitation experiences with people who have dementia. DesignCluster-randomized crossover design. SettingGeneral and psychogeriatric nursing homes in the state of Victoria, Australia. ParticipantsForty participants (20 residents and 20 carers) were recruited. InterventionDuring visits, family members interacted with their relative either through engaging in Montessori-based activities or reading a newspaper (the control condition) for four 30-minute sessions over 2 weeks. MeasurementsResidents’ predominant affect and engagement were rated for each 30-second interval using the Philadelphia Geriatric Center Affect Rating Scale and the Menorah Park Engagement Scale. The Pearlin Mastery Scale was used to rate carers satisfaction with visits. The 15-item Mutuality Scale measured the carers quality of their relationship with the resident. Carers’ mood and overall quality of life were measured using the Center for Epidemiological Studies Depression Scale and Carer-QoL questionnaires, respectively. ResultsLinear regressions within the generalized estimating equations approach assessed residents’ and carers’ outcomes. Relative to the control condition, the Montessori condition resulted in more positive engagement ( b = 13.0, 95%CI 6.3–19.7, p < 0.001) and affect ( b = 0.4, 95%CI 0.2–0.6, p < 0.001) for the residents and higher satisfaction with visits for carers ( b = 1.7, 95%CI 0.45–3.00, p = 0.008). No correction was applied to p-values for multiple comparisons. ConclusionThis study strengthens the evidence base for the use of the Montessori programs in increasing well-being in nursing home residents. The findings also provide evidence that family members are an additional valuable resource in implementing structured activities such as the Montessori program with residents.

Hurricane Sandy struck the east coast of the United States on October 29, 2012, devastating communities in its path. In the aftermath, New York implemented a home buyout program designed to facilitate the permanent relocation of residents out of areas considered to be at risk for future hazards. While home buyout programs are becoming popular as policy tools for disaster mitigation, little is known about what factors influence homeowners to participate in or reject these programs. This study used mixed methods to assess the relationship between community resilience and the relocation decision in two heavily damaged communities in which the majority of residents made different decisions regarding whether or not to pursue a buyout. The sample was composed of residents from Oakwood Beach and Rockaway Park, both working-class communities in New York City, who participated via a community survey ( N  = 133) and/or in-depth interviews ( N  = 28). Results suggested that community resilience moderated the relationship between community of residence and the buyout decision, leading to opposite responses on the buyout decision. Contextual community factors, including the history of natural disasters, local cultural norms, and sense of place, were instrumental in explaining these different responses. Implications for disaster policy are discussed.

ABSTRACTBackgroundUp to half of people with dementia in high income countries live in nursing homes and more than two-thirds of care home residents have dementia. Fewer than half of these residents report good quality of life and most older people are anxious about the prospect of moving into a nursing home. Robust evidence is needed as to the causes of admission to nursing homes, particularly where these risk factors are modifiable. MethodsWe conducted a systematic literature search to identify controlled comparison studies in which the primary outcome was admission to nursing home of older adults with dementia. Identified studies were assessed for validity and 26 (17 cohort and 9 case-control) were included. Qualitative and quantitative analyses were conducted, including meta-analysis of 15 studies. ResultsPoorer cognition and behavioral and psychological symptoms of dementia (BPSD) were consistently associated with an increased risk of nursing home admission and most of our meta-analyses demonstrated impairments in activities of daily living as a significant risk. The effects of community support services were unclear, with both high and low levels of service use leading to nursing home placement. There was an association between caregiver burden and risk of institutionalization, but findings with regard to caregiver depression varied, as did physical health associations, with some studies showing an increased risk of nursing home placement following hip fracture, reduced mobility, and multiple comorbidities. ConclusionWe recommend focusing on cognitive enhancement strategies, assessment and management of BPSD, and carer education and support to delay nursing home placement.

To evaluate the association between self-reported gun violence exposures and mental health and behavioral health indicators in a rural population. Using cross-sectional survey responses from 630 residents of a rural county in Pennsylvania, logistic regression models estimate the likelihood of residents indicating moderate or severe levels of health outcomes as a function of gun violence exposure. We control for a series of variables related to gun ownership, behavior, history with firearms and demographic characteristics. Personal firearm victimization was associated with self-reported depressive symptoms and interrupted sleep. Secondary exposure to firearm violence, particularly exposure to friends attempting or completing a suicide, was associated with higher odds of reporting severe levels (14 days or more in the past month) of depressive symptoms, anxiety, and poor sleep. For firearm suicide involving a friend or family member, the odds of reporting severe levels of all three outcomes are 3 times greater (OR 2.984, 95% CI 1.457–6.108). For each additional firearm exposure, the odds of experiencing severe levels of mental health and sleep difficulties are 1.4 times greater (OR 1.384, 95% CI 1.115–1.720). Cumulative exposures also increase the odds of reporting binge drinking and drug use. Firearm violence exposure was associated with adverse health indicators in this rural population. Approaches to counter the effects of cumulative firearm exposure and firearm suicide exposure, including reinvigorating community spaces and strengthening social supports, may help to reduce mental health burden in rural communities.

Collective efficacy is defined as residents’ perceived collective capacity to take coordinated and interdependent action on issues that affect their lives. This study explored factors associated with neighborhood collective efficacy among residents. Utilizing a national sample of 4,120 urban households provided by Annie E. Casey Foundation’s Making Connection Initiative, we investigated the mediating role of residents’ perceptions of bonding social capital (i.e. reciprocity, trust, and shared norms) in the association between civic engagement and collective efficacy. Multiple regression analyses revealed that civic engagement and bonding social capital were both directly related to collective efficacy. Additionally, bonding social capital partially mediated the relationship between civic engagement and collective efficacy. Specifically, residents who reported greater levels of civic engagement also reported higher levels of bonding social capital. In turn, residents who reported higher levels of bonding social capital also reported higher levels of neighborhood collective efficacy. We discuss implications of these findings for researchers and practitioners interested in associations of neighborhood collective efficacy.

ABSTRACTObjectivesNursing home residents with dementia are sensitive to detrimental auditory environments. This paper presents the first literature review of empirical research investigating (1) the (perceived) intensity and sources of sounds in nursing homes, and (2) the influence of sounds on health of residents with dementia and staff. DesignA systematic review was conducted in PubMed, Web of Science and Scopus. Study quality was assessed with the Mixed Methods Appraisal Tool. We used a narrative approach to present the results. ResultsWe included 35 studies. Nine studies investigated sound intensity and reported high noise intensity with an average of 55–68 dB(A) (during daytime). In four studies about sound sources, human voices and electronic devices were the most dominant sources. Five cross-sectional studies focused on music interventions and reported positives effects on agitated behaviors. Four randomized controlled trials tested noise reduction as part of an intervention. In two studies, high-intensity sounds were associated with decreased nighttime sleep and increased agitation. The third study found an association between music and less agitation compared to other stimuli. The fourth study did not find an effect of noise on agitation. Two studies reported that a noisy environment had negative effects on staff. ConclusionsThe need for appropriate auditory environments that are responsive to residents’ cognitive abilities and functioning is not yet recognized widely. Future research needs to place greater emphasis on intervention-based and longitudinal study design.